Droperidol for the treatment of nausea and vomiting (sickness) in people with advanced disease

Dorman S, Perkins P

Published Online:

October 6, 2010

Nausea (a feeling of sickness) and vomiting are common and distressing symptoms for people with advanced cancer and other life-threatening illnesses. Several medications to control these symptoms are available. Droperidol is one example which has been used to try to prevent or treat nausea and vomiting for people having surgery or chemotherapy. We found no randomised studies of droperidol for the treatment of nausea or vomiting for people receiving palliative care or suffering from an incurable progressive medical condition. Several studies reported on the use of droperidol for the prevention of nausea and vomiting associated with chemotherapy but only one of these included only patients in the palliative stage of their illness. This was a study of 32 patients with advanced lung cancer receiving chemotherapy. The addition of droperidol to dexamethasone and metoclopramide was associated with a shorter median duration of nausea although the reduction in vomiting duration and volume were not statistically significant. Further studies are needed to find out which medications are most suitable to treat nausea and vomiting in palliative care.

Abstract (click to read)

Background:

Nausea and vomiting are common symptoms in patients with terminal illness and can be very unpleasant and distressing. There are several different types of antiemetic treatments which can be used to control these symptoms. Droperidol is an antipsychotic drug and has been used and studied as an antiemetic in the management of post-operative and chemotherapy nausea and vomiting.

Objectives:

To evaluate the efficacy and adverse events (both minor and serious) associated with the use of droperidol for the treatment of nausea and vomiting in palliative care patients.

Search strategy:

We searched electronic databases including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant search terms and synonyms. The basic search strategy was ("droperidol" OR "butyrophenone") AND ("nausea" OR "vomiting"), modified for each database. The search was updated on 2 December 2009.

Selection criteria:

Randomised controlled trials (RCTs) of droperidol for the treatment of nausea or vomiting, or both, for adults receiving palliative care or suffering from an incurable progressive medical condition.

Data collection and analysis:

We judged the potential relevance of studies based on their titles and abstracts, and obtained studies which we anticipated might meet the inclusion criteria. We both read these to assess suitability for inclusion. Discrepancies were discussed to achieve consensus.

Main results:

The search strategy identified 1664 abstracts (and 827 duplicates) of which 23 studies were obtained in full as potentially meeting the inclusion criteria. On review of the full papers, no studies were identified which met the inclusion criteria, therefore, there were no included studies in this review.

Authors' conclusions:

There is insufficient evidence to advise on the use of droperidol for the management of nausea and vomiting in palliative care. Studies of antiemetics in palliative care settings are needed to identify which agents are most effective with a minimum of side effects.

This record should be cited as:

Dorman S, Perkins P. Droperidol for treatment of nausea and vomiting in palliative care patients. Cochrane Database of Systematic Reviews 2010, Issue 10. Art. No.: CD006938. DOI: 10.1002/14651858.CD006938.pub2

Assessed as up to date:

August 2, 2009

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Primary Review Group:

Pain, Palliative and Supportive Care Group

Health topics:

Cancer > Palliative and supportive care > Symptomatic relief

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Droperidol for the treatment of nausea and vomiting (sickness) in people with advanced disease

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